ABSTRACT
OBJECTIVES: Methicillin-resistant Staphylococcus aureus infections are becoming an increasing problem, but the link with symptomatic sino-nasal infection has not previously been quantified. The aim of this study was to determine the incidence of methicillin-resistant Staphylococcus aureus infection in patients undergoing sino-nasal surgery. DESIGN: A retrospective study of case notes. SETTING: A district general hospital. PATIENTS: One hundred and fifty-one adult patients undergoing in-patient endonasal surgery over a 12-month period were considered for the study. MAIN OUTCOME MEASURES: Swab results from pre-operative screening and from any intra- and post-operative samples of infective mucopus. RESULTS: One hundred and fifty-one patients undergoing endonasal surgery were included. All patients had pre-operative nasal swabs taken. Twenty-five patients had peri-operative microbiology samples taken. Only one middle meatal swab was found to contain methicillin-resistant Staphylococcus aureus. No patients had methicillin-resistant Staphylococcus aureus detected on pre-operative screening. Haemophilus influenzae was the most common organism detected. CONCLUSION: Methicillin-resistant Staphylococcus aureus infection does not represent a significant source of morbidity in our practice.
Subject(s)
Carrier State/microbiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Nasal Cavity/microbiology , Nose Diseases/surgery , Staphylococcal Infections/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Carrier State/drug therapy , Female , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Staphylococcal Infections/drug therapy , Staphylococcal Infections/epidemiologyABSTRACT
The 'one airway' model for upper and lower respiratory tract disease is a concept gaining increasing momentum in both respiratory medicine and otorhinolaryngology. The specific common aetiology and pathophysiology of concomitant bronchiectasis and sino-nasal disease, such as chronic rhinosinusitis, are discussed here, as well as the clinical manifestations, along with a review of all the relevant literature in the field.
Subject(s)
Bronchiectasis/etiology , Rhinitis/etiology , Sinusitis/etiology , Ciliary Motility Disorders/complications , Evidence-Based Medicine , Humans , Models, BiologicalABSTRACT
It is becoming increasingly important for clinicians to be able to demonstrate the effectiveness of their interventions. We have developed a rhinosinusitis--specific outcome measure (SNAQ-11) that avoids the shortcomings of the existing tools. This paper compares its use with the widely used Sinonasal Outcome Test (SNOT-20). We carried out a prospective study that involved forty patients undergoing endoscopic sinus surgery. Their SNAQ-11 and SNOT-20 scores were compared pre and post operatively. We also recorded individual symptom scores pre and post operatively in order to study the impact of surgery. The study shows a larger change in the postoperative SNAQ score compared to that in SNOT-20 (21% c.f. 11%) Although the pre and post-op changes in SNOT-20 are significant at the p = 0.005 level, the changes in the SNAQ-11 are highly significant at the p = 0.0001 level. Furthermore we have statistically confirmed that the change seen with SNAQ-11 is larger in relation to the variation in change as compared with SNOT-20 (-1.08 c.f. -0.59). Our results show that SNAQ-11 is a valid and highly relevant rhinosinusitis outcome tool. The results also confirm that Endoscopic Sinus Surgery seems especially effective at addressing nasal obstruction, congestion and facial pain/pressure, fair at anterior nasal discharge, sneezing, hyposmia and sleep disturbance and poor for post nasal drip, cough and earache.
Subject(s)
Outcome Assessment, Health Care/methods , Patient-Centered Care/standards , Rhinitis/surgery , Sinusitis/surgery , Surveys and Questionnaires , Adolescent , Adult , Aged , Endoscopy , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
The Glasgow Benefit Inventory, a validated post-interventional questionnaire, was used to determine patient benefit from septorhinoplasty according to indication (function, cosmesis or a combination) in 87 patients. We showed a very significant patient benefit from this procedure and have demonstrated that the benefit is greatest when cosmesis is an indication (P = 0.05).
Subject(s)
Outcome Assessment, Health Care/statistics & numerical data , Plastic Surgery Procedures/statistics & numerical data , Rhinoplasty/statistics & numerical data , Adolescent , Adult , Factor Analysis, Statistical , Female , Humans , Male , Middle Aged , Patient Satisfaction , Surveys and QuestionnairesSubject(s)
Submandibular Gland Neoplasms/pathology , Teratoma/pathology , Child, Preschool , Humans , MaleABSTRACT
Two cases of laryngeal smooth muscle tumours are reported: one a benign leiomyoma, the other a malignant leiomyosarcoma. These tumours may present diagnostic difficulties and immunocytochemistry is helpful in distinguishing smooth muscle tumours from other connective tissue neoplasms and spindle cell squamous carcinoma. Primary treatment in both cases should be surgical resection with small (T1, T2) malignant tumours suitable for partial laryngectomy. Postoperative radiotherapy may have a role in allowing a more limited surgical resection.
